胸痹心痛病因病机研究述评

目的：探讨胸痹心痛病因病机及其各证型与临床检测指标相关性。方法：收集整理并归纳、总结古今中外关于胸痹心痛病因病机理论研究、冠心病的病理机制及危险因素研究以及胸痹心痛各证型与临床检测指标相关性的研究资料。结果：胸痹心痛相当于西医的冠心病,系因胸阳不振,阴寒痰浊留踞胸廓,或心气不足,鼓动乏力,使气血痹阻,心失血养所致,以胸闷及发作性心胸疼痛为主要表现的内脏痹病类疾病。病机上焦阳虚,阴邪上乘,邪正相搏。现代医学研究表明,冠心病的发生与炎症反应、超敏C-反应蛋白、D-二聚体、胱抑素-C、热休克蛋白60、冠心病易感基因、脂联素等密切相关。关于胸痹心痛各证型与临床检测指标相关性研究方面,学者们做了很多有益的尝试并取得可喜进展,但观点并不统一。结论：胸痹心痛各证型与临床检测指标相关性方面,有待进一步研究。

Research Review on the Etiology and Pathogenesis of Bi Disease of the Chest and Heartache

Objective：To explore the etiology and pathogenesis of Bi disease of the chest and heartache and the correlation between clinical lab indicators and various TCM syndrome types.Methods：Research data on the theoretical study of etiology and pathogenesis of Bi disease of the chest and heartache at all times and in all over the world,study of pathological mechanism and risk factors of Coronary Heart Disease（CHD） and correlation between various TCM syndrome types and clinical lab indicators of Bi disease of the chest and heartache was collected,organized and summarized.Results：Bi disease of the chest and heartache pertained to CHD in western medicine,which was the internal disease caused by obstruction of qi and blood and failure of blood in nourishing heart due to inactivation of chest yang and pathogenic cold and sputum staying in the chest or insufficient heart-qi incapable of activating yang and manifested by chest stuffiness and paroxysmal chest pain.Its pathogenesis is yang deficiency in the upper energizer,the uprising of the yin pathogens and struggle between the evil and health qi.Modern medicine study revealed that the onset of CHD was closely related to inflammatory reaction,hypersensitive C-reactive protein,D-dimer,Cystatin C,heat shock protein 60,susceptibility gene for CHD and adiponectin,etc.With respect to the research on the correlation between various TCM syndrome types and clinical lab indicators of Bi disease of the chest and heartache,many useful studies were conducted and some progress achieved,while no consensus was achieved.Conclusion：More studies are needed to further discuss the correlation between various TCM syndrome types and clinical lab indicators of Bi disease of the chest and heartache.